Does the “Pain Scale” confuse and even scare you a bit as it does me? When I am asked by a doctor what my pain number is I freeze up. I feel like I am in grade school taking a test and am in fear of failing. I stammer out a number and then think, “Was that too high? Too low? Did I say the right thing?” It is crazy-making!
Recently I have been tracking my pain hourly on my “Healing Companion Journal,” which really has me thinking about what the numbers on the scale mean. I actually feel like I am doing something wrong marking the higher numbers (anything above a 4), like the pain police are going to call me out as inflating my answer even if I am in a lot of pain. So, I set about trying to make some real sense out of the scale.
What I found was that it really is all over the map depending on the author of the scale. I think you have to choose one that feels most comfortable to you and then stick with it. That way your numbers will have relevancy to each other from day to day.
Here are some of the scales I encountered in my search…
This one with its sad faces could be good for children, but I found it of little help with my daily fibromyalgia and osteoarthritis pain.
At first I thought this “What Is Your Weather?” scale was going to be a good one, but once I really read through it, I realized that I would be a “Snowed-In 10” almost every day.
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This one was better, but still not quite there, plus I realized that I didn’t know the true definition of the word “moderate.” I consulted the dictionary. Moderate: “kept or keeping within reasonable or proper limits; not extreme, excessive, or intense: a moderate price.” I had mistakenly been calling my much higher pain moderate because I hadn’t researched the definition. |
I found another one that I was unable to link to. However, it was the one that in conjunction with these above finally provided the answer for me. The pain scale that I am now using is:
0-1 No or very little pain
2-3 Mild pain
3-4 Discomforting
5-6 Distressing
7-8 Severe
8-9 Intense or very severe
10 Worst pain imaginable
I eliminated the word “moderate” and used “discomforting” instead. It is defined as: “something that disturbs or deprives of ease.” To me this signifies when tasks or life is becoming uneasy due to my pain level.
Distressing is actually where I am much of the time with my osteoarthritis. Distressing is defined as: “great pain, anxiety, or sorrow; acute physical or mental suffering; affliction; trouble.”
I now feel like I have a pain scale that I can work with the genuinely reflects my true level of pain or discomfort. Maybe next time the doctor asks me what my pain number is, I will be able to state it with confidence. Or maybe I will just show them my “Healing Companion Journal” so they can see for themselves!
Update: A friend pointed out another pain scale that is really excellent. You can find it here. Be sure and scroll down to get the full explanation for the numbers. Once I spend more time with it, I might have to expand my scale a bit with some more explanation. So stay tuned! 
{ 14 comments… read them below or add one }
I really like the last scale you spoke about. It would be helpful for me if you could give descriptions of the other points on the pain scale.Do you have access to those?
The last one was one I created myself based on all that I looked at and one that I could not link to. However, it didn’t have any description. That was why I went to the dictionary and looked up “discomforting” and “distressing.” Severe could be defined as “causing misery or discomfort by its harshness; hard to endure” and intense is defined as “Extreme in degree or strength.” So for level 8-9 you would put both intense and severe together. Hope that helps.
Tamara,
I love your choice of words. As a writer, I agree the nuances are important. And as you point out, it is important we understand the meanings of the words we choose so we can accurately describe our pain.
Great scale!
Yes! I am a writer also and always assumed I knew the definition of moderate when in actuality I didn’t REALLY know it well enough to be rating my pain by it. What I finally decided is that we each need to find a scale that works for US and then stick with it so that we are consistent day to day in rating our pain.
Love this Tamara. Always reaching out. What an educator you are, I am so impressed with what you have put together here. Healing, Harmony and Hope, Celeste, FM expert for Dr. Oz at Sharecare and author, Integrative Therapies for Fibromyalgia, Chronic Fatigue Syndrome, and Myofascial Pain: The Mind-Body Connection (co-author Jeff Miller, PhD)
Thank you, Celeste. Coming from you that is high praise!
Wow! That one in the update is really eye-opening. I realize that the numbers I’ve been giving my chiropractor for my headaches and neck pain after my car accident in September have been really quite low (2-3) when they should be more like 4-5. Hmmmm. Yeah.
I think it’s hard when you live with pain all the time. You tend to push it to the back of your mind & just deal with it. And then your number system becomes skewed. A “normal” day becomes a 1 or 2 when before it would have been a 4. It’s just that we’ve become so used to it and numb to it in a way…
EXACTLY! I was rating mine so much lower. Partly because I didn’t feel I had “permission” to use the high numbers, but also because when you are always in pain and used to living with it a 4 does begin to feel like a 1 or 2. Sad, isn’t it?
I was interested in seeing your pain scales. I do the same thing as you when I go to my doc. I think I am so used to always having some pain that it is hard to say unless it is intense. Thanks for sharing them. I have psoriatic arthritis as well as fibromyalgia.
I am finding it helpful to get more in touch with my pain levels so that I can more accurately tell my doctor how I am truly doing. I have lupus and osteoarthritis and right now I am finding my joint pain to be worse than my fibro pain. My rheumatologist believes that those of us with both arthritis and fibromyalgia have higher levels of joint pain. I wish I could give you his explanation, but right now it is escaping me. (brain fog) I will ask him to explain again next time I see him and then I will try to remember to post it here.
You, Tamara, are truly an inspiration!!! I stumbled upon this site from the meet-up group email I received and linked to the Healing Companion Journal. I cannot stop reading your insights and honesty…you truly inspire me to be a better, more compassionate me. Thank you!
Thank you! I am so happy that you are finding my blog helpful.
Tamara, you are right on about the pain scale. It means a lot to me that another human being feels the same way I do about it . I’m smiling and feeling awful. It’s just that I’m used to feeling pain and get confused about how to label it or quantify it. I usually have quite a bit of pain; I almost feel “it’s not your business how much pain I have. You wouldn’t understand anyway. “
I hear you, Alana. I guess they developed the scale to be more cognizant of patient’s pain levels. It is just so danged hard to put an objective number on such a subjective thing!